Incidence and Outcomes of Pregnant Trauma Patients With Positive Urine Toxicology: A Southern California Multicenter Study
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: The use of illicit substances during pregnancy has increased 4-fold in the past two decades, negatively impacting both mother and fetus. The rate and clinical outcomes of substance use in pregnant trauma patients (PTPs) are not well studied. We sought to evaluate clinical outcomes of PTPs with positive urine toxicology, hypothesizing a higher rate of in-hospital maternal complications for PTPs with a positive urine toxicology ((+)Utox) compared to those testing negative ((−)Utox). Methods: PTPs (≥18 years old) were included in this multicenter retrospective study between 2016 and 2021. We included patients with known urine toxicology results and compared (+)Utox vs (−)Utox PTPs. Results: From 852 PTPs, 84 (9.8%) had a (+)Utox with the most common illicit substance being THC (57%) followed by methamphetamine (44%). (+)Utox PTPs had higher rates of blunt head injury (9.5% vs 4.2%, P = .028), extremity injury (14.3% vs 6.5%, P = .009), domestic violence (21.4% vs 5.9%, P < .001), suicide attempt (3.6% vs 0.3%, P < .001), and uterine contractions (46% vs 23.5%, P < .001). Abnormal fetal heart tracing, premature rupture of membranes and placental injury were similar between groups (all P > .05). The rate of maternal complications was similar in both groups (all P > .05). Conclusion: In this study, the rate of (+)Utox in PTPs was 9.8%. The (+)Utox group had similar rates of maternal complications but more commonly experienced uterine contractions which may be related to the physiology of drugs such as methamphetamines. PTPs with (+)Utox also more commonly were victims of domestic violence and suicide attempt, which merits further prevention research efforts.
Source: The American Surgeon
Authors: Isabel Clark, Jeffry Nahmias, Mallory Jebbia, Negaar Aryan, Alexa N. Lucas, Nicole Fierro, Navpreet K. Dhillon, Eric J. Ley, Jennifer Smith, Sigrid Burruss, Alden Dahan, Arianne Johnson, William Ganske, Walter L. Biffl, Dunya Bayat, Matthew Castelo, Diane Wintz, Kathryn B. Schaffer, Dennis J. Zheng, Areti Tillou, Raul Coimbra, Rahul Tuli, Jarrett E. Santorelli, Brent Emigh, Morgan Schellenberg, Kenji Inaba, Thomas K. Duncan, Graal Diaz, Erika Tay-Lasso, Danielle C. Zezoff, Areg Grigorian
Institutions: University of California, Irvine, Cedars-Sinai Medical Center, University of California, Los Angeles, Harbor–UCLA Medical Center, Loma Linda University Medical Center, University of California, Riverside, Santa Barbara Cottage Hospital, Cottage Health, Scripps Memorial Hospital, Sharp Memorial Hospital, Riverside University Health System - Medical Center, University of California San Diego, University of Southern California, LAC+USC Medical Center, Ventura County Medical Center
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,950
OpenAlex ID: W4403329600